Thursday, November 17, 2011

My Near Death Experience (Part 2)

OK. It's been some months since my last post. I was writing about my last severe episode of depression. (Read up on my previous post for Part 1).

Dazed and Confused

So I'm sitting in the patrol car, desperate to find a way to carry out my plan on killing myself before they can lock me up. Perhaps they'll just take me to the hospital, have the docs talk to me, give me some pills and let me go home with my husband. Except I don't want to go home, because I can't face my family and because I already decided they'd be better off without me. Now that I'm sane again, I can see how unreasonable my thoughts were. But when you're in the pit, it's pitch dark, and the only patch of light is far away and out of reach; and the sides of the pit are slippery and the inside of it is pitch black. And the pin point of light that you see impossibly far above you is probably just the froth from the wall of water as it pours into the pit to drown you. In other words, your thinking is skewed by the depression and you aren't seeing things as they really are, but through the hopeless distorted lens of mental illness.

I had been cycling between mania and depression for months- I'm bi-polar, this happens. Normally my medications help manage this tendency, this disconnect between what's happening in my life and how I react and feel emotionally and mentally. But sometimes the meds aren't enough; they don't stop the demons from rampaging through my brain chemistry and playing havoc with my ability to think, reason and function during these episodes.

A Roller Coaster of Pain

With bipolar disorder, always after the highs come the lows. Depression follows mania like a hangover follows a drinking spree. And the higher the high, the lower the low. Sort of like riding a roller coaster that goes progressively higher and lower faster and faster until you are no longer enjoying the ride but scared you are going to be thrown off and out in the the nether. After the high always comes the crash. So following my final, highest hypo-manic episode, I came crashing down into a suicidal depression, and decided that my life was no longer worth living. I was tired of dealing with all my problems, and tired of my friends and family having to deal with all my problems. I was and would always ever only be a burden to them and to society, therefore everyone would be better off without me. Typical suicidal thinking. 'Stinking thinking' my pastor would say. The pain of depression that severe is hard for most people to imagine. They think of feeling depressed because they don't have enough money to buy all the things they want. They think of the sadness of breaking up with a boyfriend or lover. These things are depressing. Think instead of losing your child. Think of dying of cancer, the pain so severe that medication no longer relieves it. Imagine being in so much pain that you end up begging to die; begging for someone to help you to die to end the endless pointless agony. Mental suffering can be every bit as painful as physical pain. Ask any bereaved parent or spouse. The stress on your body can be as great. Stress hormone levels in the blood from great mental anguish are measurable and are as high as in cancer victims. People who suffer extreme severe depression are in that kind of pain. They are desperate to find relief from their suffering. They want it to end, and in their clouded thinking, the only way to end it is to end their lives. This was the mental state I was in as I sat in that patrol car last spring. Exacerbating my depression was a good case of Seasonal Depression Disorder; the acronym being, aptly, SAD. In this disorder, lack of sunlight exposure that typically occurs in the winter causes a deficit of the "feel good" chemicals that are released in the brain. That, added to problems and misunderstandings in my marriage at that time all added to create the "perfect storm" that led to my breakdown.

A Danger to Myself

So, to continue my story, I was brought to the emergency room, and while the nice policeman and I were waiting for me to be seen, I mentioned I needed to go the restroom (true). The door was pointed out to me and I quickly made my way there, knowing full well that in hospital restrooms there is always a cord that hangs down to the floor that is attached to an emergency switch for use by a person who has fallen and needs help. I locked the door, used the toilet, then took the cord and tied it around my throat as tightly as I could in a knot, sat down there by the commode with the cord still attached to the wall at one end and me at the other, and waited to die. It was peaceful, and though the cord pinched my neck, I could still breathe. But it was tight enough to be cutting off my circulation, thus starving my brain of oxygen and causing me to feel faint. A pleasant floaty feeling came over me. Just as the buzzing greyness of beginning unconsciousness began, the door burst open, I heard through the haze the officer exclaiming "now you've done it!", and felt him cutting through the cord around my neck with a knife. I remember feeling very disappointed that I had failed in my attempt to end my life. I heard the nurse say, "wow, just a few minutes longer and we would have lost her!" Damn! The nurse waved something very unpleasant beneath my nose that brought me to full awareness very quickly. Truly, ammonia is a most unpleasant and shocking smell. After that, everything that followed that evening is a blur. The next thing I can remember is being told there wasn't room in the psych unit at the hospital and I was being taken to the next county's psych unit, an hour away, to be admitted for observation. I knew the routine, I had been through it several times in the past. I knew that they could only legally hold me for 72 hours; then they would have to get a court order to hold me longer, deeming me a "danger to myself or to others." But I was indeed a danger- a serious threat- to myself. So spent the first three days in the psych unit in what they call the isolation room and I call the "freak-out" room. It's the room they put you in when you need to be watched more closely, and to provide you with the quite and isolation needed when you are out of control. I spent my time there alternately crying and screaming and begging to be allowed to die. I wanted out of my life and felt that I had served my "sentence" long enough and wanted it to end. Except I didn't want parole, I wanted execution! My life felt to me like one long, unending punishment. Like I was serving time for some deficit I had or some crime I had unwittingly committed against the universe. I just couldn't imagine what I had done that was so bad that it would condemn me to a lifetime of anguish. But I definitely felt that I had served long enough. I was through. Done. So I kept screaming "I want out! I've served my time. Long enough! I want out!" I was just sick and tired of being sick and tired. Tired of the constant struggle. So they gave me a minder; they call it "individual monitoring". Basically, it's a staff member who's sole job on that shift was to babysit me night and day, 24/7. That means when I'm asleep or awake.

No Privacy Allowed

I have no idea how my minders kept their sanity all that time. They were with me as I ranted and raved in the freak-out room. They were with me (albeit with their backs turned) in the shower. And since the minder must ALWAYS keep you in sight, they also are supposed to be with you in the bathroom. Not outside the door, but inside, while you are sitting on the toilet. Although I can see why they were especially insistent on not leaving me alone in the bathroom (giving my little escapade at the emergency room), this last almost caused me to get violent. This was a deal-breaker for me and I absolutely refused to allow my minder in the bathroom with me. I could hardly tolerate having a female attendant with me in the shower room. Having anyone, male or female with me in the bathroom was unthinkable. I have strong bathroom issues, no doubt related to my childhood molestation, which mostly happened there. Of course, it was inevitable that this impasse reach a crisis point. When you gotta go, you gotta go. At first no one said anything when I went into the little cubicle room that held just a toilet and a sink (no cord) and went inside and shut the door and locked it. But a supervisor on the third or fourth day realized that I was in the bathroom alone. behind a locked door, which was definitely against policy for people on "one-on-one" monitoring. So she came and insisted that my minder must go into the bathroom with me. To make matters worse, my minder that shift was a guy. Now I'm a non-violent person. I don't believe violence solves anything, and exacerbates most problems. It never entered my mind, for instance, to resist the police officer when he wanted to put me in his car, or to try to run from him or fight being taken to the hospital, or even to protest my commitment in the psych unit or it's rules. (At least not until I found myself there- then I protested loudly!) But the bathroom issue was threatening to get physical, at least for me. I told the nurse, no way, no how, not happening. She tried to persuade me. Uh uh. She tried bribing me with extra privileges. Nope. She tried negotiation. Nada. I just couldn't wrap my head around any way I could tolerate another person watching while I performed my bodily functions. And the thought of just being there with another person gave me a major panic attack. I couldn't breathe. I felt like I was having a heart attack. I threatened to crap my pants instead of going in there. They just replied that they'd put diapers on me then. Sadly, that almost seemed a better choice to me. I was crying, the nurse stood stony-faced and unyielding, and everyone else just stood around looking concerned and compassionate and helpless. She seemed unable to think of any way to work around this issue without threatening to physically restrain me and force me to sit on the toilet like a toddler being toilet trained (except I would never dream of treating a toddler that way!). I had panicky images of me clad in a straight jacket and sitting bare-assed on the toilet while a hulking male attendant stood over me. It says in my file that because of my childhood abuse history and PTSD, it is advised that I not be physically handled or have restraints or handcuffs if at all possible less I be further traumatized. And being tied up definitely would have sent me over the edge. I was facing my worst nightmare! Finally, it was me who actually found a way out of the impasse. I realized that they were only trying to insure my safety, even against myself. If I were the charge nurse, I wouldn't want a patient given the chance to hurt themselves on my shift either. So if I could think of a way they could be sure I couldn't hurt myself in the toilet, then perhaps that might satisfy their need protect me. So I suggested that they tape the door latch open, so that it can't go into the opening in the side of the doorway, thus insuring I cannot lock the door, and have enough time to hurt myself before they can use a key to open it up. (like happened in the emergency room). They taped it open with masking tape. I agreed readily that my minder could stand just outside the door, ready to snatch it open at a moment's notice if he felt he needed to. In return, I would use the toilet as quickly as I could, and if I were in there longer, I would say something so my minder new I was still OK. Thank God. I still don't know how things might have turned out if we hadn't reached that solution. But the charge nurse agreed to try it, and I never abused her trust; I cherished my privacy too much.

Diarrhea of the Mouth

As a matter of fact, I rather enjoyed having a minder. I had a captive audience at last, and used that opportunity to air my thoughts and views in an unending stream of chatter that was almost entirely one-sided. A common symptom of bipolar illness is what the doctors call "pressured speech". You might think of it as a sort of diarrhea of the mouth. You can't stop talking, it's like a hole in the dam of your mind has opened up and the words just come spewing forth out of your mouth like a volcano in an unstoppable flow.
So I spent the first three days of my confinement talking the ears off my minders. Poor souls. Can you imagine the poor guy on the graveyard shift trying to stay awake while listening to me drone on and on ranting and raving all night long? He must have thought he was in hell. But they were all kind to me there, and understanding. No one tried to tell me to shut up. No one spoke harshly to me at all. The charge nurse would just pop her head in around 3 or 4 AM to gently suggest I might want to try lying down and closing my eyes for a while. I've been in hospital psych units in this county and in the next, and the staff have always been understanding, professional, and compassionate. They have always treated me with respect and gentleness.*

I was to learn a little later that this kind of "hands-off" treatment isn't always the case. My experience at State Hospital South, to which I was eventually committed, was somewhat different. Although I managed to alienate most of the staff at both the county hospitals, they were somewhat less tolerant and forgiving at the State level. You only wind up there if you have been legally committed by a Judge. So they hold all the cards. It eventually dawned on me that at State, if I wanted any privileges at all, or to keep the ones I had, and most importantly to eventually get out, I needed to shut my mouth and be less antagonistic and obnoxious there. While they tolerated a lot of crap from patients, it was a sure bet that mouthing off or protesting the rules only lost you levels and privileges. They worked on a "level system" where you worked you way up the levels to earn more privileges. Everyone started at level 1. Which means you basically sit in the unit twiddling your thumbs all day; no TV, no magazines or books, no pencils or paper, no going out on the patio, nada. Even just being allowed to visit the hospital library or attend a class or watch TV was a privilege tied to what level you were. But until my new medication routine kicked in, I in the grips of my illness and unable to keep my mouth shut no matter how much I wanted to. So I was a real ass most of the time I was in either place, and at State, it took me almost a month before my meds starting working and I was finally to get some control back over my big mouth.

In the county psych unit, after several days of "personal attention" with my babysitters, and some new medications, I calmed down, and was no longer actively trying to kill myself. Actually, I realized right away that the unit was secure enough, and the staff watchful enough that attempting to do the deed while I was in there was useless. I told all the staff as much, so they deemed I was no longer an "immediate suicide risk" and called off my no-doubt grateful minders. I was by then likewise no longer enchanted with the experience of having someone with you night and day without a break. But they still weren't about to discharge me, although I asked to go home every day (by that time home was looking better and better all the time compared to the virtual prison I found myself in). I wasn't able to deceive the people whose job it was to examine me and determine whether I could be discharged or required further and longer treatment (commitment at State Hospital South).

Next post, I'll relate how I wound up at the State Hospital and about my experiences there. Please feel free to leave me your feedback or comments!

*I was to learn a little later that this kind of "hands-off" treatment
isn't always the case. My experience at State Hospital South, to which I
was eventually committed, was somewhat different. Although I managed to
alienate most of the staff at both the county hospitals, they were
somewhat less tolerant and forgiving at the State level. You only wind
up there if you have been legally committed by a Judge. So they hold all
the cards. It eventually dawned on me that at State, if I wanted any
privileges at all, or to keep the ones I had, and most importantly to
eventually get out, I needed to shut my mouth and be less antagonistic
and obnoxious there. While they tolerated a lot of crap from patients,
it was a sure bet that mouthing off or protesting the rules only lost
you levels and privileges. They worked on a "level system" where you
worked you way up the levels to earn more privileges. Everyone started
at level 1. Which means you basically sit in the unit twiddling your
thumbs all day; no TV, no magazines or books, no pencils or paper, no
going out on the patio, nada. Even just being allowed to visit the hospital library or attend a class or watch
TV was a privilege tied to what level you were. But until my new
medication routine kicked in, I in the grips of my illness and unable to
keep my mouth shut no matter how much I wanted to. So I was a real ass
most of the time I was in either place, and at State, it took me almost
a month before my meds starting working and I was finally to get some control back over my big mouth.

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About Me

I live in beautiful Idaho just west of the Teton Mountains and near the western gate of Yellowstone Park with my husband of 20 years and college-age son and two miniature dachshunds. In the winter, I write and teach school part-time, in the spring and summer, we have adventures, traveling all over the northwest in our travel trailer.